Polymer-based oral rehydration solution for treating acute watery diarrhoea


Germana V Gregorio, Maria Liza M Gonzales, Leonila F Dans, Elizabeth G Martinez

University of the Philippines Manila College of Medicine-Philippine General Hospital, Department of Pediatrics, Manila, National Capital Region, Philippines

Gregorio GV, Gonzales MLM, Dans LF, Martinez EG. Polymer-based oral rehydration solution for treating acute watery diarrhoea. Cochrane Database of Systematic Reviews 2016, Issue 12. Art. No.: CD006519. DOI: 10.1002/14651858.CD006519.pub3

Access the full-text article here: 10.1002/14651858.CD006519.pub3

Food-based oral rehydration solution for acute diarrhoea

What is polymer-based ORS and how might it help

Acute diarrhoea is a common cause of death and illness in developing countries. Oral rehydration solutions (ORS) have had a massive impact worldwide in reducing the number of deaths related to diarrhoea.

The original ORS was based on glucose and had an osmolarity of ≥ 310 mOsm/L (ORS ≥ 310). Glucose-based ORS with a lower osmolarity was later introduced in attempts to improve efficacy, and is considered better at reducing the amount and duration of diarrhoea. Most ORS is in the form of a sugar–salt solution, but over the years people have tried adding a variety of compounds ('glucose polymers') such as whole rice, wheat, sorghum, and maize. The aim is to slowly release glucose into the gut and improve the absorption of the water and salt in the solution.

This review updates a Cochrane Review published in 2009, and assesses the available evidence on the use of polymer-based ORS (both rice and non-rice based) versus glucose-based ORS.

What the research says

Cochrane researchers examined the available evidence up to 5 September 2016. Thirty-five trials including 4284 participants met the inclusion criteria: 28 trials included children; five included adults; and two included both. Most trials compared polymer-based ORS with a sugar–salt ORS with a particular strength (ORS ≥ 310), which is slightly more salty than the currently agreed best formula (≤ 270 mOsm/L). The trials' methodological quality varied.

In people given polymer-based ORS versus sugar-salt ORS ≤ 270 mOsm/L there was insufficient evidence to show that one is better than the other (low tovery low quality of evidence).

In those given polymer-based ORS versus sugar-salt ORS ≥ 310 mOsm/L, there was a lower amount of stool and shorter time of diarrhoea in the polymer-based ORS group. No difference was observed between the two groups regarding the number of people who needed a drip to be rehydrated. Adverse events were similar (low tovery low quality of evidence).